Do European people with Type 1 diabetes consume a high atherogenic diet? 7-year follow-up of the EURODIAB Prospective Complications Study

Background/objectives - Individuals with type 1 diabetes have a high risk of developing cardiovascular diseases, and it has been reported that they consume a high atherogenic diet. We examined how nutrient intake and adherence to current European nutritional recommendations evolved in a large cohort of European individuals with type 1 diabetes over a period of 7 years. Subjects/methods - We analysed data from the EURODIAB Prospective Complications Study, a European multicentre prospective cohort study. Standardized 3-day dietary records were employed in individuals with type 1 diabetes. One thousand one hundred and two patients (553 men, 549 women, baseline age 33 ± 10 years, duration 15 ± 9 years) had complete nutritional data available at baseline and after 7 years. We calculated mean differences in reported nutrients over time and adjusted these for age, gender, HbA1c and BMI with ANOVA models. Results - Compared to baseline, there were minor changes in nutrients. Reported protein (-0.35 % energy (en), fat (-1.07 % en), saturated fat (-0.25 % en) and cholesterol (-7.42 mg/1000 kcal) intakes were lower, whereas carbohydrate (+1.23 % en) and fibre (+0.46 g/1000 kcal) intakes were higher at the 7-year follow-up. European recommendations for adequate nutrient intakes were followed in individuals with type 1 diabetes for protein (76 % at baseline and 78 % at follow-up), moderately for fat (34, 40 %), carbohydrate (34, 41 %) and cholesterol (39, 47 %), but poorly for fibre (1.4, 2.4 %) and saturated fat (11, 13 %). Conclusion - European individuals with type 1 diabetes consume a high atherogenic diet as few patients met recommendations for dietary fibre and saturated fat. This study showed minor changes in dietary nutrients and energy intakes over a period of 7 years. Nutrition education needs particular focus on strategies to increase dietary fibre and reduce saturated fat to exploit their potential benefit.